SHM Converge Scientific Abstract ePoster Gallery-Puff Puff Puke. A Case of Pediatric Cannabinoid Hyperemesis Syndrome

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This poster presents a pediatric case of cannabinoid hyperemesis syndrome (CHS) in a 17-year-old male with chronic cannabis use, weeks of persistent nausea and vomiting, hot shower relief, and significant weight loss. Workup showed cannabinoids on urine drug screen, mild dehydration-related electrolyte changes, and no abnormality on head CT. An EGD revealed mild gastritis and nodularity.<br /><br />During the first hospitalization, standard antiemetics including droperidol, metoclopramide, and ondansetron provided little benefit, and capsaicin cream was not tolerated. Because the patient could not tolerate oral intake, TPN was started. Psychology support and relaxation techniques were added, and clonazepam was initiated and titrated from 0.25 mg BID to 0.5 mg BID. After about a week, appetite and oral intake improved, TPN was stopped, and the patient was discharged after tolerating most meals and regaining weight.<br /><br />After discharge, he briefly improved, stopped clonazepam after one day, and remained abstinent from marijuana for a little over two months before relapsing. Symptoms returned and he was rehospitalized. During the second admission, metoclopramide and ondansetron again had minimal effect, PPN was started, and psychiatry recommended haloperidol 2 mg BID with renewed psychological support. Oral intake improved slightly, and he was discharged with omeprazole and ondansetron.<br /><br />The authors conclude that the presentation and relapsing course strongly support CHS rather than another GI disorder. The case highlights the limited effectiveness of usual antiemetics and suggests possible benefit from clonazepam or haloperidol, though improvement may also reflect supportive care. Sustained marijuana abstinence remains the key preventive treatment.

Asset Subtitle

Nicole Neeley

Meta Tag

Author List Luke Weaver, Nicole Neeley, Sadori Khawaja, Shivang Chaudhary

Category Clinical Vignettes

Concept Cannabinoid Hyperemesis Syndrome

Concept Marijuana Use

Concept Cannabis Cessation

Concept Intractable Vomiting

Concept Hot Shower Relief

Distinguished Non-Finalist

Presenter Organization Saint Louis University

Presenting Author Nicole Neeley

Track Pediatric

Keywords

cannabinoid hyperemesis syndrome

CHS

pediatric case

chronic cannabis use

nausea and vomiting

hot shower relief

weight loss

clonazepam

haloperidol

marijuana abstinence

Cannabinoid Hyperemesis Syndrome

Marijuana Use

Cannabis Cessation

Intractable Vomiting

Hot Shower Relief